• Journal of Chest Surgery
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• 제21권6호
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• pp.1052-1059
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• 1988

297 cases of military personnel and 7 cases of civilian were operated in K.A.F.C.H. from January 1982 to October 1988 due to cardiovascular disease, which consist of 202 cases [66.4%] of vascular disease, 91 cases [29.9%] of cardiac disease, and 11 cases [3.6%] of pericardial disease. Mean age was 25.8*7.2[2S.D.] year of age and nearly all patients were male except 4 cases of female patient in civilian. Of the 253 cases [83.2%] of acquired disease, vascular diseases were 149 cases [583%], traumatic cardiovascular 54 [21.3%], cardiac 40 [15.8%], and pericardial 10 [4.0%]. Of the 51 cases [16.8%] of congenital diseases, cardiac anomalies were 48 cases [94.1%], vascular 2 [3.9%] and pericardial 1 [2.0%]. Open heart surgery was done in 83 cases of cardiac disease, which consists of 39 cases [46.9%] of valvular heart disease, 22 cases [26.59o] of ASD, 14 cases [16.9%] of VSD, 2 cases [2.4%] of partial ECD, and so on. Of the 6 cases [2.0%] of over-all mortality, operative death in open heart surgery was 4 cases[4.8%].

• Biomolecules & Therapeutics
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• 제24권4호
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• pp.363-370
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• 2016

Cardiovascular disease is the most common cause of death in diabetic patients. Hyperglycemia is the primary characteristic of diabetes and is associated with many complications. The role of hyperglycemia in the dysfunction of human cardiac progenitor cells that can regenerate damaged cardiac tissue has been investigated, but the exact mechanism underlying this association is not clear. Thus, we examined whether hyperglycemia could regulate mitochondrial dynamics and lead to cardiac progenitor cell dysfunction, and whether blocking glucose uptake could rescue this dysfunction. High glucose in cardiac progenitor cells results in reduced cell viability and decreased expression of cell cycle-related molecules, including CDK2 and cyclin E. A tube formation assay revealed that hyperglycemia led to a significant decrease in the tube-forming ability of cardiac progenitor cells. Fluorescent labeling of cardiac progenitor cell mitochondria revealed that hyperglycemia alters mitochondrial dynamics and increases expression of fission-related proteins, including Fis1 and Drp1. Moreover, we showed that specific blockage of GLUT1 improved cell viability, tube formation, and regulation of mitochondrial dynamics in cardiac progenitor cells. To our knowledge, this study is the first to demonstrate that high glucose leads to cardiac progenitor cell dysfunction through an increase in mitochondrial fission, and that a GLUT1 blocker can rescue cardiac progenitor cell dysfunction and downregulation of mitochondrial fission. Combined therapy with cardiac progenitor cells and a GLUT1 blocker may provide a novel strategy for cardiac progenitor cell therapy in cardiovascular disease patients with diabetes.

• 재활간호학회지
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• 제18권2호
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• pp.135-144
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• 2015

Purpose: This study was conducted to examine the effects of an individualized cardiac rehabilitation education program on knowledge about coronary artery disease (CAD), compliance of sick role and vascular health status in patients with percutaneous coronary intervention (PCI). Methods: Quasi-experimental design-based nonequivalent control group pretest-posttest design was employed. Using convenience sampling, data were collected from 60 patients who underwent PCI at S Hospital in S City from September 2014 to February 2015. For examining the effects of an individualized cardiac rehabilitation education program, knowledge about CAD, compliance of sick role and vascular health status were measured. Results: The experimental group showed statistically significant differences in knowledge about CAD (t=24.21, p<.001), compliance with sick role (t=20.81, p<.001) and vascular health status (t=15.07, p<.001) compared to the control group. Conclusion: The individualized cardiac rehabilitation education program is effective in improving knowledge about CAD, compliance of sick role and vascular health status in patients who underwent PCI. Based on the findings of this study, nursing intervention programs focusing on individualized approach will be useful for patients undergoing PCI.

• Korean Journal of Radiology
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• 제2권3호
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• pp.121-131
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• 2001

Echocardiography and catheterization angiography suffer certain limitations in the evaluation of congenital heart diseases in adults, though these are overcome by MRI, in which a wide field-of view, unlimited multiplanar imaging capability and three-dimensional contrast-enhanced MR angiography techniques are used. In adults, recently introduced fast imaging techniques provide cardiac MR images of sufficient quality and with less artifacts. Ventricular volume, ejection fraction, and vascular flow measurements, including pressure gradients and pulmonary-to-systemic flow ratio, can be calculated or obtained using fast cine MRI, phase-contrast MR flow-velocity mapping, and semiautomatic analysis software. MRI is superior to echocardiography in diagnosing partial anomalous pulmonary venous connection, unroofed coronary sinus, anomalies of the pulmonary arteries, aorta and systemic veins, complex heart diseases, and postsurgical sequelae. Biventricular function is reliably evaluated with cine MRI after repair of tetralogy of Fallot, and Senning's and Mustard's operations. MRI has an important and growing role in the morphologic and functional assessment of congenital heart diseases in adolescents and adults.

• Journal of Chest Surgery
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• 제19권1호
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• pp.58-67
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• 1986

Aggressive revascularization of the ischemic lower extremities in atherosclerotic, occlusive diseases or acute embolic arterial occlusion due to cardiac valvular disease by thromboembolectomy or an arterial bypass operation has been advocated by some authors. We have performed 68 first time vascular operations, including thromboembolectomies on RR patients with ischemic lower extremities, within an 11-year-and-6-month period, from January 1974 to June 1984. We have reviewed and analyzed our vascular operative procedures and post operative results. The patients upon whom thromboembolectomies were performed were 42 males and 13 females ranging from 5 to 72 years of age. The major arterial occlusive sites were common iliac artery in 20 cases, femoral artery in 21 cases, popliteal artery in 8 cases, common iliac artery and femoral artery in 4 cases, and femoral artery and popliteal artery in 3 cases. The underlying causes of arterial occlusive disease were atherosclerosis obliterans in 34 cases; Buerger`s disease in 3 cases; emboli due to cardiac valvular disease in 13 cases; and vascular trauma in 4 cases, including cardiac catheterization in I of those cases. Arterial bypass operations with autogenous or artificial vascular prosthesis were done in 31 cases. Amputations were done on 2 patients carrying out any more vascular operative procedures would have been of no benefit to them. Our bypass operations for ischemic lower extremities were classified as follows: those done between the abdominal aorta and the femoral artery in 17 cases, including those done between the aorta and the bifemoral arteries with a Y graft in four of those cases and long ones done from the axillary to the femoral artery in 4 cases. Five patients died in the hospital following vascular surgery for ischemic lower extremities, the causes of death were not directly related to the vascular reconstructive operative procedures. The leading causes of death were respiratory failure due to metastatic lung carcinoma: renal failure due to complications from atherosclerosis obliterans; sepsis from open, contaminated fractures of the tibia and fibula; and myocardial failures due to open heart surgery in one case and reconstructive surgery of the ascending aorta in another.

• Journal of Chest Surgery
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• 제25권11호
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• pp.1192-1202
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• 1992

Postoperative cardiac outputs and other hernoaynamic values were serially measured in fifteen patients of cyanotic congenital heart disease, after use of blood cardioplegic solution. Cardiac indices showed no change untill eight postoparative hours, then it began to decline to reach as low as 3.22$\pm$0.7L/min/m2 at 12 hours. After then gradual increse occ-ured to recover upto immediate postoperative value at 20 hours. Sharp decrese of heart rate and increse of systemic vascular resistance during 8~16 hours and steady increase of stroke indices during the whole study periods were observed. These observations suggested that the myocardium recovered gradually after open heart surgery, and that the decrease of cardiac indices during 8~16 hours could be a result of decrease of heart rates and increase of afterload. The changes of cardiac indices correlated with the changes of heart rate, postoperative time and mixed venous oxygen saturation [p<0.05]. No other hemodynamic values found to be in statistically significant correlation with the changes of cardiac indices. Left ventricular dysfunction seemed to occur more frequently during 8~12 hours, but it was not statistically significant. [p=0.73] In conclusion, great care must be taken during 2~3 days after the operation of cyanotic congenital heart disease, not to fall into a low cardiac output state, by maintaing adequate heart rates and reducing afterload especially when the systemic vascular resistance increases.

• Journal of Chest Surgery
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• 제39권3호
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• pp.201-207
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• 2006

배경: 경피적 심폐 보조장치(PCPS)는 체내의 가스교환과 혈액의 관류를 간접적으로 도와줌으로써, 장기를 회복시키기 위한 다른 치료법의 사용을 용이하게 하고, 여러 다양한 임상 상황에서 출혈의 위험성을 최소화하면서 심각한 심폐부전에 빠진 환자의 생명을 구해준다. 본 저자들은 허혈성 심질환자들에서 발생한 심인성 쇼크 혹은 심정지를 PCPS로 치료한 경험을 보고하고자 한다. 대상 및 방법:1999년 5월부터 2005년 6월까지 발생한 심정지 혹은 심인성 쇼크 환자들을 대상으로 연구가 진행되었고, 환자들 중 7명에서 원심펌프인 Biopump (Medtronic inc., Minneapolis, MN), 나머지 13명에게는 자가 priming이 되는 헤파린-코팅된 EBS (Terumo, Japan)를 사용하였다. 삽관은 모든 환자에서 대퇴동맥과 대퇴 정맥을 통해서 이루어졌으며, 동맥용 케눌라는 17 Fr에서 21 Fr까지, 정맥용은 21 Fr에서 28 Fr까지 의 DLP (Medtronic inc., Minneapolis, MN) 또는 RMI (Edwards lifescienc LLC, Irvine, CA)의 비교적 긴 정맥용 케눌라를 사용하였다. 결과: 소생을 목적으로 PCPS가 시도되었던 총 20명의 환자들 중에서 심정지가 13명이었으며, 심인성 쇼크였던 환자가 7명이었다. 이들 중 11명에서 관동맥 우회술이 시행되었고, 나머지 9명의 환자에서 PCPS한 상태에서 경피적 관동맥 중재술이 시도되었다. 평균 PCPS가동 시간은 38$\pm$42시간이었으며, 총 20명의 환자들 중 PCPS 이탈이 가능하였던 11명($55\%$)의 환자 중 총 8명($40\%$)의 환자가 특별한 합병증 얼이 평균 27$\pm$17일만에 퇴원하였다. 퇴원한 환자는 현재 모두 생존하여 치장 31개월째 외래 추적관찰 중이다. 결론: PCPS를 시행함으로써 혈역학적 회복을 가져옴으로써 다른 방법으로는 살리기 힘들었던 심정지 또는 심인성 쇼크로부터 환자를 구할 수 있고, 일단 회복된 환자들은 장기 생존율을 보인다.

• Journal of Chest Surgery
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• 제14권1호
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• pp.9-16
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• 1981

Twenty eight patients with conpnital heart disuse underwent lung biopsy to assets pulmonary obstructive vascular disease at cardiac surpry. Thirteen patients had patent ductus arteriosus, 10, ventricular septal defects and S, atrial septal defects. The aaes were between 2 and 30 years. In patients with patent ductus arteriosus lung biopsy was performed from the IIngular Hlment. The anterior seament of the right upper lobe was blopsled in cases with ventricular septal defect and atrial septal defect. Grading of pulmonary obstructive vascular disease could not be assessed In 9 cases. In 2 cases poor quality of the slides made us impossible to evaluate and In 7 cases there were no suitable small muscular arteries to evaluate in the slides of lung tissue especially taken from the IIngular seament. Nineteen cases were evaluated pulmonary obstructive vascular disease. Among them 17 cases had Heath-Edwards changes of grade 1 and 2 patients had that of grade 3. The thickness of media was measured. It was expressed as percentage of medial thickness to outer diameter of artery. The medial thickness was correlated proportionally with elevation of pulmonary arterial pressure and pulmonary vascular resistance to systemic vascular resistance ratio. There were no complications related to the procedure of lung biopsy.

• Biomolecules & Therapeutics
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• 제29권6호
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• pp.697-697
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• 2021

• Biomolecules & Therapeutics
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• 제21권3호
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• pp.196-203
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• 2013

Recent accumulating studies have reported that hypoxic preconditioning during ex vivo expansion enhanced the self-renewal or differentiation of various stem cells and provide an important strategy for the adequate modulation of oxygen in culture conditions, which might increase the functional bioactivity of these cells for cardiac regeneration. In this study, we proposed a novel priming protocol to increase the functional bioactivity of cardiac progenitor cells (CPCs) for the treatment of cardiac regeneration. Firstly, patient-derived c-$kit^+$ CPCs isolated from the atrium of human hearts by enzymatic digestion and secondly, pivotal target molecules identified their differentiation into specific cell lineages. We observed that hCPCs, in response to hypoxia, strongly activated ERK phosphorylation in ex vivo culture conditioning. Interestingly, pre-treatment with an ERK inhibitor, U0126, significantly enhanced cellular proliferation and tubular formation capacities of CPCs. Furthermore, we observed that hCPCs efficiently maintained the expression of the c-kit, a typical stem cell marker of CPCs, under both hypoxic conditioning and ERK inhibition. We also show that hCPCs, after preconditioning of both hypoxic and ERK inhibition, are capable of differentiating into smooth muscle cells (SMCs) and cardiomyocytes (CMs), but not endothelial cells (ECs), as demonstrated by the strong expression of ${\alpha}$-SMA, Nkx2.5, and cTnT, respectively. From our results, we conclude that the functional bioactivity of patient-derived hCPCs and their ability to differentiate into SMCs and CMs can be efficiently increased under specifically defined culture conditions such as short-term hypoxic preconditioning and ERK inhibition.